Younger people need to enroll

So much of the news the past few months has been dominated by the foibles of the Affordable Care Act.

Michelle Singletary

So much of the news the past few months has been dominated by the foibles of the Affordable Care Act.

Yet the truth of how good or bad various parts of this major piece of health reform are won't be known for a long time.

But I like the way the nonpartisan Kaiser Family Foundation has been looking at the provisions of the ACA and providing straightforward evaluations. During a webinar for journalists Tuesday, two of the foundation's experts laid out their concerns for what we are likely to see going forward, especially as it relates to young adults.

You've probably heard that if not enough young folks sign up in the health care exchanges run by the federal government and the states, insurance premiums will rise catastrophically. The lack of participation might result in a "death spiral."

And what does that mean, you might ask?

We've been told that to make the risk pool less risky you need a significant number of healthy young people to sign up for insurance. That's why there has been a lot of focus on the group called the "young invincibles." If they don't enroll, the sicker people in the risk pool, who people expect will enroll in significant numbers, will drive up costs, and premiums. If that happens, healthy people in the pool may bail, driving up costs even more - the spiral effect.

But even if the exchanges don't get a sufficient number of young adults, it's not going to be as bad as you have heard, said Larry Levitt, co-director of Kaiser's Program for the Study of Health Reform and Private Insurance. Levitt is the co-author of a new report "The Numbers Behind 'Young Invincibles' and the Affordable Care Act." He talked about the findings in the report during the webinar.

"Because premiums are still allowed to vary substantially based on age, the financial consequences of lower enrollment among young adults are not as great as conventional wisdom might suggest," the report said.

What the exchanges need are healthy people of all ages, Levitt said: "Getting old invincibles in the market is just as important as getting young invincibles."

So what additionally should you expect from the implementation of the ACA in the coming year?

If you manage to get through the exchanges and sign up for insurance, before you visit a doctor in the new year be sure you're covered. Things are running pretty tight to deadlines, and errors are being found. So call the insurance provider you signed up with to be sure they've got you in the system. "People who think they are enrolled may not be," Levitt said.

Additionally, if you've signed up, please pay and on time. Just signing up doesn't mean you are covered. You've got to pay your premium.

Now that HealthCare.gov is running better, it's important that there be enough people available to help enrollees evaluate their options and take advantage of any tax credits they are eligible for, she said.

Contact Michelle Singletary, a financial columnist at The Washington Post, at michelle.singletary@washpost.com.